BootCamp for Betics Blog

1. REFLECT A RECENT ANNOUNCEMENT BY TRUMP
2. MORE THOROUGHLY DESCRIBE THE HISTORY AND POTENTIAL IMPACT OF USING HIGH RISK POOLS TO COVER PEOPLE WITH PRE-EXISTING CONDITIONS

Trump definitely wants insurance companies to cover pre-existing conditions. Someone is going to have to pay for it, and it might be you.

Today is Friday, November 11 and the sticky, sweaty shit storm of election dust has not yet settled, but, I’m going to chill the heck out for a few minutes here so that I can share what the reversal and replacement of Obamacare might mean for people with diabetes.

Despite the fact that Donald Trump has said that he wants to continue to cover people with pre-existing conditions, his policy makers, according to his website, have decided to make it extremely difficult for people with pre-existing conditions to get insurance coverage if they've had a gap in coverage. Here's what's on Trump's website as of November 11, 2016:

The Administration also will work with both Congress and the States to re-establish high-risk pools – a proven approach to ensuring access to health insurance coverage for individuals who have significant medical expenses and who have not maintained continuous coverage.

Now, the way this is written, to the untrained eye, it sounds kind of good, right? Sounds like Trumpcare is going to cover people with pre-existing conditions.

But, to the well-trained eye, this statement is a half-assed squirt of Febreze on a rug saturated with cat piss.

To be clear, as a policy, BootCamp for Betics doesn’t argue ideology or have political opinions except as it directly relates to people and communities affected by diabetes.

And boy, does this ever.

The imminent repeal and replacement of the ACA could affect your diabetes care and coverage in a very undesirable way. So listen up, folks.

The first thing I'm going to do is translate Trump's website's policy statement for you to make sure you understand what it really says:

The Administration also will work with both Congress and the States to re-establish high-risk pools.A high risk pool is a group of sick people who need more medical care than other, regular, healthy people, and these sick people cost insurance companies a lot of money. So, with the new Trumpcare plan, people with pre-existing conditions will be taken OUT of the regular group and put into a high risk group. This means that regular people who aren't sick can pay less for their insurance premiums, while people with pre-existing conditions will either have to pay for a private plan at a much higher rate than regular, healthy people OR that people with pre-existing conditions can apply for insurance through their state risk pool.- a proven approach to ensuring access to health insurance coverage for individuals who have significant medical expensesSounds great, right? If you can't afford the jacked up private insurance rate for your pre-existing condition, just sign up through the high risk pool! Wait. Wait. Let's talk more about that. Risk pools, back in the day (before Obamacare), were largely run by the states and they operated at a loss. Funding came from various sources, some state, some federal. Often, there wasn't enough money in the high risk fund to subsidize everyone, so people with pre-existing conditions had to go on a waiting list. So, your ability under Trumpcare to procure an insurance plan from a state high risk pool may be limited depending on what state you live in, what type of care you need, and whether or not the state pool even has the money to subsidize you. This creates risk and uncertainty. The truth is, we have no idea exactly how Trumpcare plans to cover people with pre-existing conditions.and who have not maintained continuous coverageThere just isn't a way to actually pay for pre-existing conditions for people who've had a gap in insurance. That's what's missing from Trump's plan.

Ok, let's move on.

The next thing I'd like to do is provide encouragement to our president-elect, and to congressional leaders, to continue to find a way to provide affordable, and not prohibitively expensive, healthcare coverage for people with diabetes (and for other sick people) as they work through the imminent reversal and replacement of Obamacare (or whatever Trump & congressional republicans decide to do).

​Do you want to write your senator or representative? Scroll down to download and print my letter templates.

Finally, I'd like to help those of us with Diabetes hedge against insurance loss so that you don't get totally fucked. Read on, my friends.

Do you have diabetes?

Here's what you need to do to hedge against potential insurance loss:

1. If you don't have it, get insurance NOW. If you and your spouse both have jobs, and if you can afford it, consider getting double-insured. This may seem excessive, but the truth is, we just don't know what's going to happen and I am very risk-averse when it comes to healthcare. I've been screwed too many times. If you have insurance through your employer, you are in the best possible position right now. Don't quit your job. If you don't have insurance through your employer, go to healthcare.gov and enroll. If you don't currently have health insurance, your opportunity will be lost when open enrollment closes unless you experience a qualifying event. Let me put this another way. If you don't have 2017 insurance coverage by January 31, 2017 you could be in trouble whenever Trumpcare takes effect (probably 2018). Listen. If you already have insurance coverage when the new healthcare law takes effect, it will be more difficult (though not impossible) for your insurance company to jack up your rates and/or deny your diabetes coverage. If you can't afford insurance, sell your clothes, ask your family members for money, or stop grocery shopping and start eating peanut butter sandwiches.

2. Call, email or write your senators and your representative (you can download a template below) to see if they'll reconsider their position on pre-existing conditions. Do it now, because they are already working on the ACA's replacement.

3. Start saving money.

4. Do what you can to get your blood sugars into target range as often as possible. The sooner you do this, the better. A lower A1C means fewer health problems, and if you're on your own next year without insurance, you'll need to do everything you possibly can to keep yourself healthy so that you can continue to stay alive.

To be clear, NONE of this is certain. No one knows what is going to happen. It's the level of risk and uncertainty regarding pre-existing conditions that I'm uncomfortable with.

Obamacare has its problems, but it also has some features that support the lives of people with diabetes.

I’d like to encourage congress, in its effort to repeal and replace Obamacare, to consider continuing to support healthcare coverage for people with diabetes.

Don't want to use facebook for comments? Scroll down to use the old-school comments tool

I've been divided on Obamacare thus far. I'm a type one and have been for over 30 years. I was on Ohio's high risk pool insurance prior to Obamacare and it was better coverage and cost less. That may not be true in every state, but this was my experience. I have been self-employed for several years and don't have access to group coverage. My current coverage costs close to $400 each month with a $5000 deductible. The Ohio high risk pool cost $239 per month with a $2000 deductible.and was not based on your income which was a plus for me also. I don't know what the answer is, but just wanted to let you know my own personal experience.

Thanks so much for your comments and for sharing your personal experience! Obamacare has indeed been such a mixed bag. Some people ended up much better off, with healthcare that they desperately needed and didn't have before, and others ended up paying more money out-of-pocket for the same plan or an even worse plan.

I suspect that, as a nation, we'll have a similar experience with Trumpcare. Some people will be better off, while others will be worse off.

It is my hope that people with diabetes will not be any worse off than we are right now.

Reply

Chris

11/11/2016 03:15:56 pm

Ive been dx for 33 years. As a kid I couldn't go see a endo because I couldn't get on my moms insurance due to preexsisting. I was in the hospital ever month or 2 with dka. Now In my mid 30's I am paying for it with all the wonderful complications. If other countrys can do universal health care why cant we? non are perfect but something is better then nothing. Want to fix oboma care just axe the part that forces people to have coverage.

It does, but I still recommend it because of the uncertainty. No matter how you feel about Trump, it's true that he isn't always consistent with his messaging, and often changes his mind; Thus, my recommendation is to double insure against the risk. There's no guarantee that you'll be able to get coverage under your spouse's plan if you lose your job under Trumpcare and there's no guarantee that if you DO end up signing on to your spouse's plan after Trumpcare is implemented, that your diabetes care will be covered. There's no guarantee of anything, really. Except that if you lose your job, it's a pretty big deal.

Thanks,
Kara

Reply

Sheri

12/9/2016 10:54:30 am

Yes, losing a job is a problem for diabetics and their health insurance coverage. However, you just deal with it. My husband lost his job and we paid over $1000 a month COBRA until he got his new job and coverage (about 5 months worth). I have also had cancer, so I could not lose the continuous coverage. I'm sure people are going to say "Sure, you could afford this", but we've had to pay COBRA before and had numerous job changes to deal with. It's something we know is going to happen and has to be dealt with. Affording it was not optional. Admittedly, getting one's finances in order definitely helps, but that should be part of what one does to take care of their diabetes. There are all kinds of options out there. Planning ahead and realizing that one has to deal with the reality of diabetes is just prudent.

I do agree insulin is way over priced, but in part that is because there is insurance and people can get coverage. It's a two-edged sword.

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Author

Hi, I’m Kara. I’ve been type 1 diabetic since 1986. I’ve been attending diabetes camp since 1987. I’ve been a camper, a counselor, a staff director and training director at diabetes camps for the last 30 years. I have a regular day job as a technology consultant, and even though I like my day job, diabetes is my true passion. My late maternal grandmother had diabetes, and died from complications related thereto. Both of my grandfathers have diabetes, and so do my dad and my uncle. My little brother is hyperinsulinemic, which means that his pancreas is already overproducing insulin to counteract his body's insulin resistance. I hate diabetes! But guess what. Diabetics aren't doomed. There is a way to have diabetes and still live a long and healthful life, but, at times, it can be hard as hell. Like, really, really, insanely hard. But I’ve finally figured out how to lower my blood sugars and keep my A1C at a reasonable level. And it's not easy, and sometimes I screw up, but my method is totally workable for anyone who wants to fix their blood sugar, including you. And I want to share what I’ve learned with you, so that you can be healthy and feel better, too.